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Discussion Starter · #1 ·
Hi,<br>
I need to buy a new oxygen tank and am wondering what kind to buy. Cascade has several and I really don't understand enough about them to know the difference.<br><br>
What is everyone using? (for those that carry oxygen at all)?<br><br>
thanks
 

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The tanks are different sizes....I would think a size D would be fine, unless you plan on using it a lot (which depends on how many births you attend, etc.) The E tank is only a bit more, holds more oxygen, but is more cumbersome to haul around.<br>
Another thing to consider is where you will get it filled. Here in California, Oxygen is considered a medical supply - and you have to have some sort of license/prescription to purchase it. If that might be a problem for you, a bigger tank might be less hassle.<br>
Then you need a regulator and pressure gauge, tubing and mask.<br>
I keep both an adult and infant mask in my birth bag.<br>
I also use an ambu-bag in case I have to "bag" the baby. This is connected to the pressure gauge so that when bagging you don't accidently use too much pressure and cause a pneumothorax.<br>
Cascade has a regulator that has both regulator and pressure valve.<br>
Hope that helps...<br>
Carla
 

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Discussion Starter · #3 ·
thanks for that info. I searched around with some other midwives, seems they get their filled by telling the folks they are welders. So I guess I will send my husband in their with the tank and tell them he's a welder.<br><br>
What about scuba divers? What do they do to get their tanks filled? Or are theirs different? I don't know much about that, obviously.<br><br>
I bought all my supplies now except I could still use some extra instruments, the tank and a new doppler, I want a waterproof one. I need to wait until I do my next birth for the money for that!
 

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What type of doppler are you going to get?<br>
I have a few older ones - but they aren't made anyone, and I would like to have a waterproof model.<br>
Are you getting it from Cascade?<br>
Glad you got the oxygen straight...<br>
I don't know anything about scuba diving....lol, except if i'm scooping out a baby at a waterbirth !!!!!<br>
Carla
 

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it might be worth calling a local scuba instructor and asking...I've wondered the same thing myself.<br><br>
I caution against buying your tank, though, until you shop around from the place you'll be getting your oxygen. If you are getting medical oxygen, most companies will include the price of the tank, regulator, tubing and mask in an initial fee. Also, even at welding places, you don't get to keep "your" tank: you take the empty or used one in and trade for a full one, so spending a lot on a tank is a waste. You'll keep the regulator and tubing, though, so money spent on a reliable regulator isn't wasted.
 

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I like the small tanks...they are easy to fit under my arm and carry. I used to have to trade them when they got empty and sometimes i would end up with a really crummy big huge tank. Eventually I bought my own.....and now I keep 4 filled tanks, 2 small and 2 large for back up. When they get low, I send them to the local medical supply business and they refill them, so I am only paying for the oxygen and not the cost of the tank rental. Either way, it works.<br>
I believe scuba divers use a mix of oxygen and nitrogen - nitrox. I believe that they also have to use some type of lubrication, as oxygen is very drying....that's why babies receiving oxygen under a hood need to have moisture added also.<br>
If you know any OB nurses....when they are expecting a difficult delivery, they set up the table for the baby - which includes an oxygen mask, tubing and ambu bag. Even if the baby doesn't use it, it is tossed, considered not-sterile. The nurses will save the clean ones for me so I don't have to buy a new one each time.<br>
Carla
 

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I'm curious about how everyone uses oxygen. I know that a lot of research has been done showing how using pure oxygen during resuscitation leads to brain damage, and how guidelines are changing to reflect that and advising that you use room air when bagging... So I've been debating about carrying it myself when the time comes.<br><br>
Any thoughts sage femmes? When and for what do you use it?
 

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I'm always hoping NOT to use it...but, I use it if I have to transfer the mother for fetal distress, or if she has had a hemorrhage, or is in shock, or for other emergencies.<br>
I use it for the baby as recommended by NRP (neonatal resuscitation program) guidelines.<br>
Even NRP recognizes that there is insufficient evidence for using oxygen, but they do recommend oxygen when a baby is cyanotic or when PPV (positive pressure ventilation) is needed in a term baby. For me it's always a last resort after giving the baby some time to come around, using gentle stimulation, and maybe suctioning if it took a huge gulp of fluid.....<br>
I usually set the tank up and put it out of the way...but it has been a lifesaver once or twice.....<br>
Carla
 

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I've only used oxygen in the case of fetal distress and would use it as guided by NRP guidelines, if needed (it hasn't been needed yet, but I know someday it will). While helping mom breathe more effectively often works well, there have been a couple of times when putting mom on oxygen has just worked so much BETTER. One was a case with a transport for fetal distress (found later that babe had a two vessel cord and velamentous insertion). One case was when mom only breathed about every 3 seconds during pushing and heart tones were getting too low for too long. Oxygen reminded her of the importance of breathing and heart tones came back up. I think she was on oxygen for a total of 15 minutes at the end of second stage.<br><br>
I used to think the decisions not to carry oxygen was totally irresponsible and wreckless, but I'll be honest, at some births I've only had just enough oxygen to give blow-by to baby if needed and I'm okay with that.
 

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Oxygen masks for mom can enforce her "personal space"- I find them claustrophobia inducing, but I've seen two moms that felt less watched and more in the zone with the mask on.<br>
Oxygen could be very important to a baby with a heart or lung defect. Otherwise, 20% oxygen (room air) is perfectly fine for inflating lungs (PPV) and offering oxygen to the aveoli for exchage into the bloodstream. Unless you've got a resevoir...you're not delivering 90-100% even though you have a tank. The amount varies with the type of set up you have.<br>
Ebay is a good place to shop for equipment - it gives you an idea of price, regulators, bags, and stuff, even if you buy locally. Some regulators are much harder to use than others, I've found.<br>
It concerns me that so many midwives re-use non-reusable bags. I understand and support re-use when they are purely set-up and taken down at birth after birth. But once used to resusitate a baby, it should be chucked out or autoclaved, especially if the baby is suspected of having GBS infection. Can you tell I used to be a microbiologist? <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"><br>
I heard that most divers use compressed room air in their tanks, not 100% oxygen, and that welder's oxygen can have non-human-safe grease residue b/c the equipment used to concentrate the O2 is not lubed with medical grade waxes. I don't know the truth of that though, just reporting a rumor.<br>
I do know that an oxygen concentrator that takes room air and extracts the oxygen to fill the tank sometimes go for $1500 on ebay. It'd be a great resource for a large group of midwives to get if the refill service is not available.
 

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Anyone here have experience getting a tank filled in a state where DEMs are illegal?
 

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you get oxygen for birthing farm animals, scuba rescue, welding, some old person you know has an rx, you have an emt fill it for you, you get an rx from someone (depends on the state often a chiro will be helpful), one client had a dentist family member who provided oxygen, friends and family ties- who do you know or are serving that may be resourceful.<br>
NRP guidelines--- and just to note that using oxygen with a self inflating ambu bag does not deliver 100% oxygen- nor does blow by with a mask or cupped hand-<br>
---- in the past I have given mom some oxygen when heart tones were low but did not ever seem to work and interfered with mom moving around, and having her change position seemed to work better- now I have accompanied moms who were on O2 masks for hrs in the hospital and I could not comment too much about it's use there- if it does work there is no way I could provide that much oxygen for that long and so it would not be for me to do/decide/provide.
 

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i would only use oxygen on a mom who was shocky. never on babies. i've used it myself w citrus essential oils to energize me at a long birth.
 

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I would use oxygen on a mom if the baby had ominous heart tones. I would not use it on the newborn.<br><br>
I never thought about using it on myself! Does it perk you up?
 

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Protocols.
 

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<div style="margin:20px;margin-top:5px;">
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<div>Originally Posted by <strong>Sheena</strong> <a href="/community/forum/post/7408205"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">I would use oxygen on a mom if the baby had ominous heart tones. I would not use it on the newborn.<br><br>
I never thought about using it on myself! Does it perk you up?</div>
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Using it on mom for fetal distress is not evidence-based - are the protocols yours or your states? Things like that need to change!<br><br>
It does work to perk yourself up! I use a mask with a cotton ball with a couple drops of lemon essential oil on it. Some good deep breaths does wonders!
 

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This is where the discussion gets interesting.....even though there is lack of evidence that oxygen does anything for fetal distress...the malpractice attorney's push that fact.....here is an example from prominent Ca. attorney website...<br><br>
"Our attorneys and experts have identified negligence in cases involving difficult forceps deliveries, difficult vacuum extractions, exceptionally long labor and delivery, low amniotic fluid, twisted, compressed or compromised umbilical cords, a baby that is large for its gestational age, a placental abruption, and any other sign of lack of oxygen and/or trauma. Our attorneys will analyze electronic fetal......"<br><br>
The doctors I work with figure that oxygen may not help, but it won't hurt either....and even the EMT's use oxygen for transport of moms.....<br><br>
To me, this is where being a midwife gets difficult....<br><br>
Carla
 

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so true, Carla. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"> It's why modern obstetrics is not evidence-based.<br><br>
I had a client who had lower heart tones (pretty normal type when the head comes through the cervix) and the mw that was assisting me panicked and threw an O2 mask on her. In her second pregnancy, she told me that it was very scary and made her feel totally clausterphobic.<br><br>
I've heard that giving O2 for fetal distress is really about "provider distress" - however physiologically, it makes no sense that increased O2 levels to mom will improve baby. I've seen baby's heart rate pick up sometimes, but I credit that to increased adrenaline and heart rate of mom...usually because of the panic of providers.
 

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I found this on Ronnie Falco's site.....<br>
What do you think?<br><br>
Techniques Confirmed to Improve Fetal Oxygen Status During Labor By Anthony J. Brown, MD - June, 2005 [Medscape registration is free].<br><br>
"NEW YORK (Reuters Health) Jun 03 - Researchers have shown that three intrauterine resuscitation techniques commonly used to improve fetal oxygen status during labor are indeed useful when the fetal heart rate (FHR) pattern is nonreassuring, according to a report in the June issue of Obstetrics & Gynecology.<br><br>
These techniques are: giving the mother an IV fluid bolus of 1000 mL, placing her in a lateral position, and administering O2 at 10 L/min with a non-rebreather face mask. . . . "
 
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